title: Epidemiology of rheumatoid arthritis in a tertiary care unit, Karachi, Pakistan.
abstract: OBJECTIVE
  To determine the frequency, demographic characteristics, associated co- morbidities and extraarticular manifestations in patients with rheumatoid arthritis (RA) visiting the rheumatology clinic at a tertiary care hospital, Karachi.
  
  
  METHODS
  A retrospective medical chart review of 4900 patients, who visited the rheumatology clinic at Liaquat National Hospital, from January 2005 to June 2007, was conducted. All patients with RA, of both gender and ages 16 years and above, who fulfilled the 1987 ACR criteria were included. Demographic characteristics, base line co-morbidity and extra-articular manifestations were recorded according to pre-defined criteria.
  
  
  RESULTS
  Among 4900 patients, 633 (12.9%) visited the rheumatology clinic with RA, female to male ratio being 4:1. The mean age of onset was 38.5 +/- 12.4 years in females and 44.8 +/- 13.12 years in males. Among the age group 16-29 years females were more affected, whereas greater number of males presented between 50-75 years of age. Co-morbidities were found in 35.38% of RA patients. Cardiovascular disease including hypertension (13.79%) and ischaemic heart disease (6.6%) were the most common co-morbidities. RA factor was positive in 85.05% of the patients with hypertension and 88.09% of the patients with ischaemic heart disease. Extra-articular manifestations were reported in 3.47% of patients. Interstitial lung disease (1.57%) was the most common extra-articular manifestation.
  
  
  CONCLUSIONS
  Significant proportion of patients with female predominance visited the rheumatology clinic at a tertiary care hospital due to RA. Rheumatoid factor may predict the risk of developing cardiovascular disease in patients with RA. The frequency of extra-articular manifestation was lower than that reported in western population.
authors.affiliation: Department of Rheumatology, Liaquat National Hospital, Karachi.
authors.forename: Syed Mahfooz
authors.initials: SM
authors.lastname: Alam
authors.forename: Aneela Altaf
authors.initials: AA
authors.lastname: Kidwai
authors.forename: Syed Raza
authors.initials: SR
authors.lastname: Jafri
authors.forename: Bilal Mazhar
authors.initials: BM
authors.lastname: Qureshi
authors.forename: Amber
authors.initials: A
authors.lastname: Sami
authors.forename: Harith Hilal
authors.initials: HH
authors.lastname: Qureshi
authors.forename: Haris
authors.initials: H
authors.lastname: Mirza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents